β-Cell Dysfunction Is Associated with Metabolic Syndrome Severity in Adults
β-Cell Dysfunction Is Associated with Metabolic Syndrome Severity in Adults
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DOI：
10.1089/met.2013.0083
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发表时间：
2014-03-01
影响因子：
2.1
通讯作者：
Kirwan, John P.
中科院分区：
文献类型：
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作者：
Malin, Steven K.;Finnegan, Stephen;Kirwan, John P.
背景：代谢综合征在成年人中普遍存在，其特征是内脏脂肪增多和胰岛素抵抗（IR）。然而，胰腺β细胞功能与成人代谢综合征严重程度之间的联系在整个葡萄糖谱中是未知的。我们假设β细胞功能差将独立预测较高的代谢综合征Z评分（即，方法：70名（12名正常糖耐量，37名前驱糖尿病，21名2型糖尿病）肥胖成人[62.4 ± 1.1岁; 34.6 ± 0.6 kg/m2;数据为平均值±平均值标准误（SEM）]参与了这项横断面研究。进行2小时75克口服葡萄糖耐量试验（OGTT），测定胰岛素和葡萄糖曲线下面积以计算胰岛素作用。使用胰岛素分泌的稳态模型评估（HOMA-B）和胰岛素生成指数（即，I 0 -30/Glc（0-30）或I60-120/Glc（60-120））。空腹和餐后胰岛素敏感性分别用HOMA-IR和Matsuda指数评估。β-细胞功能通过HOMA-B/HOMA-IR、I 0 -30/Glc（0-30）或I60-120/Glc（60-120）xMatsuda指数使用处置指数来估计，其分别代表基础、第一和第二时相胰岛素释放。身体成分（通过计算机断层扫描和双X射线吸收测定法）和性别特异性代谢综合征Z-分数计算腰围，血压，空腹血糖，甘油三酯，和高密度脂蛋白。结果：与正常葡萄糖耐量相比，内脏脂肪和IR较高，β细胞功能较低的成人葡萄糖耐量异常和2型糖尿病。内脏脂肪和IR（HOMA-IR和Matsuda指数）升高与Z评分升高相关（r=0.51，r=0.54，r=-0.49;所有P
Background: Metabolic syndrome is prevalent in adults characterized by increased visceral adiposity and insulin resistance (IR). However, the link between pancreatic beta-cell function and metabolic syndrome severity in adults across the glucose spectrum is unknown. We hypothesized that poor beta-cell function would independently predict a higher metabolic syndrome Z-score (i.e., severity).Methods: Seventy (12 normal glucose tolerant, 37 prediabetic, 21 type 2 diabetic) obese adults [62.4 +/- 1.1 year; 34.6 +/- 0.6 kg/m(2); data are mean +/- standard error of the mean (SEM)] participated in this cross-sectional study. A 2-hr 75-gram oral glucose tolerance test (OGTT) was administered, and insulin and glucose area under the curve was determined for calculations of insulin action. Fasting and glucose-stimulated insulin secretion was calculated using homeostasis model assessment of insulin secretion (HOMA-B) and the insulinogenic index (i.e., I0-30/Glc(0-30) or I60-120/Glc(60-120)), respectively. Fasting and postprandial insulin sensitivity was assessed by HOMA-IR and the Matsuda Index, respectively. beta-cell function was estimated using the disposition index via HOMA-B/HOMA-IR, I0-30/Glc(0-30) or I60-120/Glc(60-120)xMatsuda Index, which represents basal, first-, and second-phase insulin release, respectively. Body composition (via computerized tomography and dual X-ray absorptiometry) and sex-specific metabolic syndrome Z-scores were calculated from waist circumference, blood pressure, fasting glucose, triglycerides, and high-density lipoproteins.Results: Compared to those with normal glucose tolerance, visceral fat and IR were higher and beta-cell function was lower in adults with glucose intolerance and type 2 diabetes mellitus. Elevated visceral fat and IR (HOMA-IR and Matsuda Index) correlated with elevated Z-scores (r=0.51, r=0.54, r=-0.49; all P